To order your
Emergency Alert Sentinel today !!!

By Phone: ............Call 1-800-747-1434. If paying by credit card, have your card number and expiration date available.

By FAX: ............Complete this form, print it and FAX it to 1-800-360-4820. Be sure to include your card number and its expiration date.

By Mail:...............Complete this form , print it and it along with your check or money order to:

Information
Date:
First Name:	Last Name:
Company:*
Shipping Address:
City:	State:	Zip Code:
Phone:*	FAX:*	E-Mail:*
Optional*

---

Payment Information

Which Payment Method would you like to use? We accept VISA, Discover, MasterCard, checks and money orders VISA Discover MasterCard Check Money Order
If payment will be by Credit Card, please provide the following Information:

Credit Card Number:

Expiration Date:

---

Optional - Where did you hear about the Emergency Alert Sentinel?

---

Pricing

The list price per unit is $54.95 + shipping and handling. Iowa sales tax of $2.75 per unit shall be included for Iowa residents.

For example, if you are from Alabama and would like to order an Emergency Alert Sentinel, the total charge would be $60.95, for two it would be $119.90. If you are from Iowa, one unit would be $63.70. Discounts are available for orders of three or more units and for EMA personnel.

---

Shipping and Handling Information

Your Emergency Alert Sentinel will be shipped UPS ground. If other means of shipping are requested, different shipping and handling charges may apply. If you are purchasing multiple units, shipping and handling will be adjusted as follows:

One Unit - $6.00 per Unit	Six to Ten Units - $15.00 total	Quantity
Two Units - $10.00 total	Eleven + Units - Actual Shipping will apply
Three to Five Units - $12.00 total

---

Feedback or Special Instructions

ASI would like to hear from our customers. Enter your comments or suggestions in this OPTIONAL field. Use this spot for any special instructions you may have about delivering your order as well.

 

Close this Window to Return to ASI Industries